Eating disorders are frequently just one sign of deeper emotional struggles.
Rogers Behavioral Health’s Dr. Carolyn Turcott, MD, psychiatrist, medical director, Eating Disorder Recovery inpatient and residential care for adults, explains why co-occurring mental health conditions are common and how ongoing support can make recovery more sustainable.
What other mental health challenges often accompany eating disorders?
People with eating disorders often experience another mental health challenge at the same time, known as a co-occurring condition. For example:
- Depression: It can lead to low appetite or lack of interest in food.
- Anxiety: Worry and fear can prevent a person from eating.
- OCD: Obsessions about germs or contamination may cause someone to avoid certain foods.
- Thought disorders: Delusions, such as believing your food is poisoned, can make eating difficult.
How common is it to have an eating disorder and another mental health challenge?
I would say probably 90% of people we see in inpatient eating disorder treatment have another mental health challenge.
Why do people with an eating disorder struggle with another mental health condition?
The core reason many people have an eating disorder alongside another mental health condition is difficulty coping with emotions. Their brain is using eating — or not eating, such as restricting, binging, or other eating disorder behaviors — as a way to cope with difficult feelings and situations because they don’t have more positive or healthy coping skills.
As an example, people with anorexia tend to have issues around control. Restricting food can give them a sense of control over painful memories about past abuse, stress at work or home, or intense anxiety. Social situations might also be challenging, especially if they don’t have a lot of friends and they worry about how they are perceived.
What are signs that could indicate that someone has more than an eating disorder?
One major concern that brings people to inpatient treatment is safety. By that I mean a person is engaged in self-harm or has suicidal thoughts.
Other signs of an additional mental health challenge could be:
- Obsessive thoughts
- Feelings of worthlessness or guilt
- Intense and paralyzing anxiety
- Decreased energy
- Chronic low mood
- Loss of interest in performing daily tasks at home, school, or work, including self-care
- Loss of interest or pleasure
How does mental health treatment help with an eating disorder?
In inpatient care, we focus on safety and limit a person’s ability to restrict or hide their food, purge, or over-exercise.
Mental health treatment provides people with support and skills, such as learning to deal with anxious thoughts, communicating with their family, and handling life’s stressors.
What I like about working at Rogers is that we’re able to help people continue their care. Once someone is medically stable, they have the opportunity to receive more in-depth, 24/7 support in residential treatment, typically for 30 to 90 days. Treatment teams, including therapists and behavior specialists, help people continue to work on their recovery by practicing coping skills and improving their body image and family relationships.
Once a person returns home, we can provide structured weekday support through our partial hospitalization and intensive outpatient programs.
Why is continuation of support important when you have an eating disorder?
Daily guidance is important when a person is new to recovery and dealing with daily stressors.
I think it’s really tough to go from inpatient treatment, where there’s 24/7 support, to being on your own. Seeing a therapist once a week isn’t adequate guidance to maintain meal plans and practice healthy coping skills without slipping back into binging, purging, or other eating disorder behaviors. Eating disorders have a high relapse rate, and a gradual peeling back of support is what seems to work best for most people.
What does recovery from an eating disorder and co-occurring mental health condition look like?
I usually tell people it’s two steps forward and one step back for eating disorder and co-occurring mental health condition recovery. Recovery for most people isn’t a straight, upward path. People usually experience setbacks, and that’s okay. Initially, recovery is uncomfortable physically and emotionally as a person learns to use more positive coping skills. I talk with my patients about the importance of planning how they’re going to deal with their stressors and building a support team for when they leave Rogers.
I think the people who do the best are those who don’t let the bad days snowball. Instead, they get back up on the horse, so to speak. If they miss a meal or two, they can say to themselves, “That’s just one day. I was having a bad day. Tomorrow, I’m going to get right back to it and I’m going to stay with my meal plan.” Recovery is about being resilient in the face of challenges outside of the treatment program. It’s an ongoing process. You’re never “done.”
Eating disorder treatment at Rogers
Hope and healing are within reach. We provide eating disorder and other mental treatment that works for children, teens, and adults.
Call 833-308-5887 for a free, confidential screening.
Yes. It’s very common for people with eating disorders to also experience conditions such as anxiety, depression, obsessive-compulsive disorder (OCD), or other mental health challenges. These are called co-occurring conditions and often need to be treated together for lasting recovery.
Eating disorders and conditions like anxiety or depression often share underlying causes, such as difficulty coping with emotions, stress, trauma, or low self-worth. Eating disorder behaviors may become unhealthy ways of managing overwhelming feelings.
Signs can include persistent anxiety, obsessive thoughts, feelings of guilt or worthlessness, chronic sadness, loss of interest in daily activities, low energy, self-harm, or suicidal thoughts. A mental health evaluation can help identify co-occurring conditions.
Treatment typically addresses both the eating disorder and the underlying mental health condition. Depending on a person’s needs, care may include medical stabilization, therapy, nutrition support, coping skills training, medication, and different levels of ongoing treatment.
Recovery is an ongoing process, and the risk of relapse is higher when support ends too quickly. Gradually transitioning from intensive treatment to outpatient care helps people continue practicing healthy coping skills, maintain meal plans, and manage everyday stressors.
